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2025 CPT code 78430

Myocardial perfusion imaging, positron emission tomography (PET), single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan.

When performed during stress, report the appropriate stress testing code (93015-93018) in addition to 78430. Ventricular wall motion and ejection fraction are included in the code and should not be reported separately.Modifier 26 should be used for the professional component and TC for the technical component if billed separately.

Modifiers 26 (Professional Component) and TC (Technical Component) can be used to report the professional and technical components separately, if applicable. Modifier 52 (Reduced Services) should be appended if the procedure is discontinued.

Medical necessity is established by the presence of signs, symptoms, or conditions that suggest a cardiac abnormality requiring evaluation of myocardial perfusion, such as chest pain, shortness of breath, or abnormal electrocardiogram findings.

The physician injects a radioactive tracer into the patient's bloodstream, which is taken up by the heart muscle. A PET scanner detects the radiation emitted by the tracer to create images of the heart. A CT scan is acquired concurrently for attenuation correction and anatomical localization. The physician interprets the images to assess myocardial perfusion, ventricular wall motion, and ejection fraction.

IMPORTANT:78491 (without CT)78431 (multiple studies)78432 (combined with metabolic evaluation, dual radiotracer, without CT)78433 (combined with metabolic evaluation, dual radiotracer, with CT)93015-93018 (stress testing codes, when performed with stress)

In simple words: This is a nuclear imaging test that uses a PET scan along with a CT scan to create detailed pictures of your heart. It shows how blood flows to and from the heart muscle, and it can also measure how well your heart pumps blood with each beat. The test can be done while you are resting or during a stress test, which involves either exercise or medication to make your heart work harder.

Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motion[s] and/or ejection fraction[s], when performed); single study, at rest or stress (exercise or pharmacologic), with concurrently acquired computed tomography transmission scan.

Example 1: A patient with suspected coronary artery disease undergoes a myocardial perfusion PET scan with CT at rest and during pharmacologic stress to evaluate blood flow to the heart muscle., A patient with a history of myocardial infarction undergoes a myocardial perfusion PET scan with CT to assess the viability of the heart muscle., A patient with heart failure undergoes a myocardial perfusion PET scan with CT to evaluate the function of the heart muscle.

Documentation should include the indication for the study, type of stress test performed (if any), and the interpretation of the images, including assessment of myocardial perfusion, ventricular wall motion, and ejection fraction.

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